WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC (EIN 62-1816368)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-11
- IRS object ID
- 201921319349300327
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-11T15:39:38-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621816368 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLMONT HAWKINS COUNTY MEMORIAL | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WELL | BusinessNameControlTxt |
| Phone | 4233023374 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1905 AMERICAN WAY | AddressLine1Txt |
| City | KINGSPORT | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37660 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | REGINA DAY | PersonNm |
| Person Title | ADMIN HCMH & HCH | PersonTitleTxt |
| Phone | 4233023374 | PhoneNum |
| Signature | 2019-05-11 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 151.102.241.104 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-11 | IPDt |
| IP Tm | 15:39:38 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | B63603CA6CC0E7A9B40672C01A3D6D8A952705BD | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 39095CF110B0C8EE9B5E629A9826572B753F4624 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | REGINA DAY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 851 LOCUST STREET | AddressLine1Txt |
| City | ROGERSVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37857 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,077,393 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | BALLADHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2000 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | MISSION: HONOR THOSE WE SERVE BY DELIVERING THE BEST POSSIBLE CARE. VISION: TO BUILD A LEGACY OF SUPERIOR HEALTH BY LISTENING TO AND CARING FOR THOSE WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 2 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 219 | TotalEmployeeCnt |
| Total Volunteers | 7 | TotalVolunteersCnt |
| Total Gross UBI | $3,939 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $2,939 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $10,639 | PYContributionsGrantsAmt |
| CY Contributions Grants | $31,048 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $42,567,481 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $18,960,790 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,894 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $269,998 | PYOtherRevenueAmt |
| CY Other Revenue | $76,253 | CYOtherRevenueAmt |
| PY Total Revenue | $42,853,012 | PYTotalRevenueAmt |
| CY Total Revenue | $19,068,091 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $636 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,267,968 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,161,982 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $34,162,043 | PYOtherExpensesAmt |
| CY Other Expenses | $7,636,780 | CYOtherExpensesAmt |
| PY Total Expenses | $42,430,647 | PYTotalExpensesAmt |
| CY Total Expenses | $16,798,762 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $422,365 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,269,329 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,851,930 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,005,431 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,984,336 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,518,537 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,867,594 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,486,894 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | HONOR THOSE WE SERVE BY DELIVERING THE BEST POSSIBLE CARE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $12,728,890 | ExpenseAmt |
| Revenue | $18,960,790 | RevenueAmt |
| Desc | WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL, INC. (WHCMH) IS A PUBLIC TRUST. THIS HOSPITAL, LIKE THE OTHER WELLMONT HEALTH SYSTEM FACILITIES OF WHICH IT IS A MEMBER, WAS BORN OF ITS COMMUNITY'S COMMITMENT TO PROVIDE SUPERIOR HEALTH CARE FOR ITS CITIZENS. WE HAVE WORKED TOWARD IMPROVING OUR COMMUNITY'S ACCESS TO QUALITY, AFFORDABLE HEALTH CARE, IMPROVING THE HEALTH STATUS OF OUR COMMUNITIES AND CONTRIBUTING TO THE OVERALL QUALITY OF LIFE IN THE AREAS WE SERVE. (CONTINUED ON SCHEDULE O) (CONT'D) IN FISCAL YEAR 2018, WE PROVIDED SERVICES TO 924 INPATIENTS, HAD 169 INPATIENT AND OUTPATIENT SURGICAL CASES, AND HAD 14,603 EMERGENCY ROOM VISITS. WE ARE MINDFUL OF OUR RESPONSIBILITIES AS ONE OF HAWKINS COUNTY'S LARGEST EMPLOYERS. HUNDREDS OF FAMILIES COUNT ON US FOR THEIR LIVELIHOODS. OUR AREA RELIES ON US AS A DRIVER OF ECONOMIC DEVELOPMENT. IT IS OUR DUTY AS A CORPORATE CITIZEN TO SUPPORT THOSE ENDEAVORS AND CAUSES THAT IMPROVE THE QUALITY OF LIFE IN OUR REGION. AND WE ALSO RECOGNIZE IT IS OUR RESPONSIBILITY TO CARE FOR THOSE IN NEED - REGARDLESS OF THEIR ABILITY TO PAY. WHCMH SERVES AS A CLINICAL TRAINING FACILITY FOR HEALTH PROFESSION STUDENTS. WE DEDICATE STAFF TO WORK WITH REGIONAL COLLEGES AND PROGRAMS TO COORDINATE PLACEMENT OF HEALTHCARE PROFESSION STUDENTS AS PART OF THEIR EDUCATIONAL CURRICULUM. IN ADDITION TO CLINICAL TRAINING, THE HEALTH CARE STUDENTS ARE REQUIRED TO HAVE ORIENTATION AND COMPUTER TRAINING. PARTICIPATING IN THE HANDS-ON TRAINING THIS YEAR WERE OT/PT, EMT/PARAMEDIC AND OTHER ALLIED HEALTH DISCIPLINE STUDENTS. THE COST TO THE HOSPITAL WAS APPROXIMATELY 30,000 TO PROVIDE TRAINING TO 22 PARTICIPANTS. WE SUPPORT AND ENCOURAGE OUR EMPLOYEES TO GIVE THEIR TIME TO AREA NOT-FOR- PROFIT ORGANIZATIONS, WHICH INCLUDED THE AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY, THE ROGERSVILLE HERITAGE ASSOCIATION, CIVIC GROUPS SUCH AS KIWANIS AND ROTARY, VARIOUS UNITED WAY AGENCIES AND THE ROGERSVILLE AREA CHAMBER OF COMMERCE AND ITS PROGRAMS. MANY OF OUR EMPLOYEES ALSO SERVE IN COMMUNITY RESCUE SQUADS. THE BEST WAY TO KEEP OUR COMMUNITIES HEALTHY IS TO PROVIDE THEM WITH THE LATEST INFORMATION ABOUT THEIR HEALTH. WE STRIVE TO PROVIDE INFORMATION ABOUT EVERYTHING FROM DISEASE AND INJURY PREVENTION TO THE LATEST TREATMENTS AND TECHNOLOGIES AVAILABLE TO COPING WITH DISEASE AND ITS SYMPTOMS. CHARITY CARE: WHILE REIMBURSEMENT FOR HEALTHCARE SERVICES IS CRITICAL TO THE OPERATION AND SUSTAINABILITY OF THE HOSPITAL, WHCMH RECOGNIZES ITS OBLIGATION TO PROVIDE CARE TO INDIVIDUALS WHO CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, INCLUDING EMERGENCY CARE. ALL PATIENTS ARE ACCEPTED REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT IS APPROVED FOR FINANCIAL ASSISTANCE (CHARITY) WHEN THEY MEET THE ESTABLISHED POLICIES OF BALLAD HEALTH AND GUIDELINES OUTLINED BY THE FEDERAL GOVERNMENT. HOWEVER, FINANCIAL ASSISTANCE DECISIONS ARE NOT SOLELY BASED ON INCOME. UNIQUE FINANCIAL CIRCUMSTANCES ARE WEIGHED WITH VERIFIED PATIENT ASSETS WHICH CAN DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY. IT IS NOT UNTIL AFTER VERIFICATION OF INCOME AND ASSETS THAT A DECISION REGARDING THE AMOUNT OF FINANCIAL ASSISTANCE CAN BE MADE. IN FISCAL YEAR 2018, WHCMH INCURRED A LOSS OF 1,525,111 ATTRIBUTABLE TO THE PROVISION OF CHARITY CARE. TENNCARE/MEDICAID: WHCMH PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, SUCH AS TENNCARE (TENNESSEE RESIDENTS) AND MEDICAID (VIRGINIA RESIDENTS). WHCMH INCURRED A LOSS OF 1,937,487 PROVIDING CARE TO THIS POPULATION OF PATIENTS DURING THE YEAR. UNINSURED DISCOUNT: UNINSURED PATIENTS RECEIVED A 76% PERCENT DISCOUNT THROUGH OCTOBER 31, 2018, AT WHICH TIME THE UNINSURED DISCOUNT DECREASED TO 74%. CERTAIN ELECTIVE PROCEDURES ARE NOT ELIGIBLE FOR THE UNINSURED DISCOUNT. THIS UNINSURED DISCOUNT IS CALCULATED EACH YEAR IN ACCORDANCE WITH TENNESSEE REGULATIONS AND WITHOUT REGARD TO A PATIENT'S INCOME OR ASSETS. THE APPROXIMATE COST OF THIS DISCOUNT IN FY18, USING THE HOSPITAL'S COST TO CHARGE RATIO, WAS 363,026. THE HOSPITAL PROVIDES MEETING SPACE FOR THE MONTHLY MEETINGS OF ALCHOLICS ANNONYMOUS. | Desc |
| Total Program Service Expenses | $12,728,890 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 15 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 219 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 2 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (true) | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | TN | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LYNN KRUTAK | PersonNm |
| Phone | 4233023374 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 MED TECH PARKWAY SUITE 300 | AddressLine1Txt |
| City | JOHNSON CITY | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37604 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| BARTON HOVE RETIRED 1312018 | ||||||||
| PRESIDENT/WH | 0.10 | 31.90 | Yes (X) | Yes (X) | $0 | $1,219,926 | $49,559 | |
| GARY MILLER | ||||||||
| TREAS/SR VP | 0.10 | 49.90 | Yes (X) | Yes (X) | $0 | $520,874 | $27,097 | |
| TODD DOUGAN (END 4302018) | ||||||||
| SEC/FIN INTE | 0.10 | 44.90 | Yes (X) | Yes (X) | $0 | $488,418 | $36,727 | |
| REBECCA BECK | ||||||||
| PRESIDENT-WH | 32.00 | 8.00 | Yes (X) | $0 | $180,488 | $25,104 | ||
| REGINA DAY | ||||||||
| ADMIN HCMH & | 40.00 | Yes (X) | $0 | $168,966 | $294 | |||
| GEORGIA SHUCK | ||||||||
| DIRECTOR PHA | 40.00 | $125,676 | $0 | $623 | Yes (X) | |||
| VIRGINIA JEFFERS | ||||||||
| EXEC DIR-PT | 40.00 | $110,959 | $0 | $1,085 | Yes (X) | |||
| ELIZABETH MANN | ||||||||
| CHARGE NURSE | 40.00 | $108,646 | $0 | $33 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $345,281 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,578,672 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $140,522 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| QUEST DIAGNOSTICS | ||||||
| 1201 S COLLEGEVILLE ROAD | COLLEGEVILLE | PA | 19426 | LAB SERVICES | $979,015 | |
| MEDSTREAM ANESTHESIA | ||||||
| 82 PATTON AVENUE | ASHEVILLE | NC | 28801 | CRNA COVERAGE | $317,100 | SUITE 510 |
| SODEXO INC & AFFILIATES | ||||||
| PO BOX 536922 | ATLANTA | GA | 30353 | MANAGEMENT SVCS | $296,690 | |
| NEW MILLENIUM HEALTHCARE | ||||||
| 555 MT CARMEL ROAD | MOSHEIM | TN | 37818 | MRI SCANS | $249,700 | |
| AMERICAN PHYSICIAN PARTNERS | ||||||
| 5121 MARYLAND WAY | BRENTWOOD | TN | 37027 | ED PHY COVERAGE | $223,408 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $31,048 | RelatedOrganizationsAmt |
| Total Contributions | $31,048 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT CARE REVENUE - NET | 621990 | $18,817,888 | $18,817,888 |
| RENT TO EXEMPT AFFILIATES | 621990 | $139,756 | $139,756 |
| PHYSICAL THERAPY REVENUE | 621990 | $3,146 | $3,146 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $18,960,790 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $15,308 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,302 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,006 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,006 | TotalRevenueColumnAmt |
| Exclusion | $6,006 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| CAFETERIA/ VENDING REVENUE | 900099 | $60,251 | $60,251 | |
| EMPLOYER PROVIDED PARKING | 900099 | $3,939 | $3,939 | |
| TN COLLEGE OF APPLIED TECH. | 900099 | $854 | $854 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,203 | TotalRevenueColumnAmt |
| Exclusion | $5,203 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $70,247 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,068,091 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,960,790 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $3,939 | UnrelatedBusinessRevenueAmt |
| Exclusion | $72,314 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,749 | TotalAmt |
| Management And General | $220,749 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,073,464 | TotalAmt |
| Program Services | $5,554,573 | ProgramServicesAmt |
| Management And General | $1,518,891 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,699 | TotalAmt |
| Program Services | $143,957 | ProgramServicesAmt |
| Management And General | $5,742 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,278,108 | TotalAmt |
| Program Services | $877,900 | ProgramServicesAmt |
| Management And General | $400,208 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $439,962 | TotalAmt |
| Program Services | $413,916 | ProgramServicesAmt |
| Management And General | $26,046 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,342 | TotalAmt |
| Program Services | $59,342 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,093,750 | TotalAmt |
| Program Services | $2,341,987 | ProgramServicesAmt |
| Management And General | $1,751,763 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $447,985 | TotalAmt |
| Program Services | $401,197 | ProgramServicesAmt |
| Management And General | $46,788 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $657,667 | TotalAmt |
| Program Services | $656,667 | ProgramServicesAmt |
| Management And General | $1,000 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,430 | TotalAmt |
| Program Services | $23,843 | ProgramServicesAmt |
| Management And General | $3,587 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $409,201 | TotalAmt |
| Program Services | $409,201 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $811,506 | TotalAmt |
| Program Services | $770,931 | ProgramServicesAmt |
| Management And General | $40,575 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,025 | TotalAmt |
| Management And General | $7,025 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,043,162 | $1,043,162 | |
| DUES & SUBSCRIPTIONS | $35,740 | $835 | $34,905 |
| RECERTIFICATION/LICENSING | $26,202 | $25,002 | $1,200 |
| BANK CARD & PROCESSING | $4,666 | $4,666 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,104 | TotalAmt |
| Program Services | $6,377 | ProgramServicesAmt |
| Management And General | $6,727 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,798,762 | TotalAmt |
| Program Services | $12,728,890 | ProgramServicesAmt |
| Management And General | $4,069,872 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,752 | BOYAmt |
| EOY | $75,534 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $506,964 | BOYAmt |
| EOY | $2,377,041 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $345,264 | BOYAmt |
| EOY | $366,586 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $17,070,618 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $13,237,389 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,962,950 | BOYAmt |
| EOY | $3,833,229 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $353,041 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,851,930 | BOYAmt |
| EOY | $7,005,431 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,984,336 | BOYAmt |
| EOY | $1,152,232 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $366,305 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,984,336 | BOYAmt |
| EOY | $1,518,537 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,867,594 | BOYAmt |
| EOY | $5,486,894 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,867,594 | BOYAmt |
| EOY | $5,486,894 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,851,930 | BOYAmt |
| EOY | $7,005,431 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,269,329 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $1,349,971 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,500 | OtherCostOrOtherBasisAmt |
| Book Value | $30,500 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,024,966 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,894,592 | DepreciationAmt |
| Book Value | $2,130,374 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $161,642 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,323 | DepreciationAmt |
| Book Value | $138,319 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,287,984 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,850,201 | DepreciationAmt |
| Book Value | $1,437,783 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $565,526 | OtherCostOrOtherBasisAmt |
| Depreciation | $469,273 | DepreciationAmt |
| Book Value | $96,253 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,833,229 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE FROM AFFILIATES | Desc |
| Book Value | $353,041 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $353,041 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO THIRD-PARTY PAYORS | Desc |
| Amt | $366,305 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $366,305 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | WELLMONT HAWKINS COUNTY MEMORIAL, INC. IS INCLUDED IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF BALLAD HEALTH. THE FOOTNOTE EXPLANATION RELATIVE TO INCOME TAXES READS: "BALLAD IS CLASSIFIED AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS SUCH, NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR BALLAD AND ITS TAX-EXEMPT SUBSIDIARIES. BALLAD'S TAXABLE SUBSIDIARIES ARE DISCUSSED IN NOTE L. BALLAD HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS AT JUNE 30, 2018. AT JUNE 30, 2018, TAX RETURNS FOR MSHA AND WHS FOR 2015 THROUGH 2017 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE." | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 2.250000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 4.500000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,525,111 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,525,111 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09080 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,866,179 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,928,692 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,937,487 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11530 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,391,290 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,928,692 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,462,598 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.20610 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $30,238 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $30,238 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $40,238 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $40,238 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,431,528 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,928,692 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,502,836 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.20850 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,526,442 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $3,293,541 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,972,629 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$679,088 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLMONT HAWKINS CO MEM HOSPINC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 851 LOCUST STREET | AddressLine1Txt |
| City | ROGERSVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37857 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | BALLADHEALTH.ORG/LOCATIONSHOSPITALS | WebsiteAddressTxt |
| State License | 0000000060 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLMONT HAWKINS CO MEM HOSPINC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | BALLADHEALTH.ORG/LOCATIONSHOSPITALS | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | BALLADHEALTH.ORG/LOCATIONSHOSPITALS | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 225.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 450.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | BALLADHEALTH.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | BALLADHEALTH.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | BALLADHEALTH.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, WELLMONT HAWKINS CO MEM HOSP,INC - PART V, LINE 3E | THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL, INC., CONDUCTED IN 2016, PROVIDED A BROAD OVERVIEW OF THE HEALTH STATUS OF THE COMMUNITY SERVED AS OUTLINED IN THE REPORT, REVEALING THAT THE REGION SUFFERS FROM HIGHER RATES OF DIABETES, CARDIOVASCULAR DISEASE, AND BEHAVIOR RELATED CANCERS (RELATED TO SMOKING, OBESITY, SEDENTARY LIFESTYLE, ETC.). THAT ASSESSMENT WAS POSTED PUBLICLY AND HAS BEEN USED IN THE INTERVENING YEARS TO SHAPE THE PRIORITIZED COMMUNITY BENEFIT INVESTMENTS MADE BY THE SYSTEM TO PARTNER WITH COMMUNITY ORGANIZATIONS. PARTNERSHIPS HAVE BEEN FORMED WITH OTHER ORGANIZATIONS. THE CHNA CONTINUES TO INFORM PROGRAMMATIC INVESTMENTS MADE BY THE HEALTH SYSTEM TO SUPPORT EFFORTS SUCH AS NURSE CONNECT THAT IS AVAILABLE THROUGHOUT OUR REGION. NURSE CONNECT, A DEPARTMENT OF WELLMONT HEALTH SYSTEM, IS A 24/7 TOLL-FREE PHONE LINE AVAILABLE TO EAST TENNESSEE AND SOUTHWEST VIRGINIA RESIDENTS THAT CONNECTS CALLERS WITH EXPERIENCED NURSES AROUND THE CLOCK WHO PROVIDE MEDICAL ADVICE, MAKE REFERRALS TO PRIMARY CARE PROVIDERS OR PHYSICIAN SPECIALISTS, PROVIDE HEALTH INFORMATION AND RESOURCES INCLUDING HEALTH SCREENINGS AND IMMUNIZATIONS, AND PROVIDE INFORMATION ON URGENT CARE CLINIC LOCATIONS. |
| FACILITY 1, WELLMONT HAWKINS CO MEM HOSP,INC - PART V, LINE 5 | INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES, INCLUDING: -PHYSICIAN NEEDS ASSESSMENT -COMMUNITY HEALTH FACILITY ASSESSMENT -MENTAL HEALTH NEEDS ASSESSMENT -PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION -PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION, INCLUDING AMERICA'S HEALTH RANKINGS AND THE COUNTY HEALTH RANKINGS -STATE AND REGIONAL HEALTH DEPARTMENT DATA -THE SOUTHWEST VIRGINIA HEALTH AUTHORITY'S BLUEPRINT FOR HEALTH ENABLED PROSPERITY -THE ETSU, WELLMONT, MOUNTAIN STATES COMMUNITY WORK GROUP PROJECT -OTHER STUDIES SIGNIFICANT INFORMATION WAS GLEANED FROM A PROCESS CONDUCTED BY THE ETSU COLLEGE OF PUBLIC HEALTH AND SUPPORTED BY BOTH WELLMONT HEALTH SYSTEM AND MOUNTAIN STATES HEALTH ALLIANCE. COMMUNITY WORKGROUPS WERE FORMED, INVOLVING A CROSS SECTION OF SUBJECT MATTER EXPERTS TO ASSESS REGIONAL HEALTH NEEDS, INCLUDING THOSE OF UNDERSERVED PEOPLE, FAMILIES, CHILDREN AND THOSE SUFFERING FROM MENTAL HEALTH AND SUBSTANCE ABUSE CHALLENGES. REGIONAL MEETINGS WERE ALSO HELD WHICH INCLUDED REPRESENTATIVES OF THE COMMUNITY AT LARGE, PATIENTS AND MINORITIES OR AGENCIES SERVING THEM. FINDINGS FROM THIS WORK WERE TAKEN INTO ACCOUNT IN BOTH THE ASSESSMENT AND IMPLEMENTATION PLAN. THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION. STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED, UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTH CARE ORGANIZATIONS AND PHYSICIANS. |
| FACILITY 1, WELLMONT HAWKINS CO MEM HOSP,INC - PART V, LINE 6A | - BRISTOL REGIONAL MEDICAL CENTER - HOLSTON VALLEY MEDICAL CENTER - LONESOME PINE HOSPITAL - HANCOCK COUNTY HOSPITAL - MOUNTAIN VIEW REGIONAL MEDICAL CENTER |
| FACILITY 1, WELLMONT HAWKINS CO MEM HOSP,INC - PART V, LINE 11 | KEY FINDINGS NOTED DURING THE CHNA WERE THE LOW RANKINGS OF THE COUNTIES WE SERVE IN SEVERAL CATEGORIES RELATED TO HEALTH AND WELLNESS, INCLUDING PREVALENCE OF CHRONIC DISEASE MANAGEMENT, TOBACCO USE, DIET AND EXERCISE, AS WELL AS A NEED FOR EXPANDED AND ENHANCED MENTAL HEALTH SERVICES. THE FINDINGS ALSO EMPHASIZED THE VULNERABILITY OF OUR UNDERINSURED AND UNINSURED POPULATIONS, AND THAT IF OUR COMMUNITIES ARE TO THRIVE, WE MUST FOCUS ON ENCOURAGING HEALTHY CHILDREN AND FAMILIES. TO HELP MEET THESE NEEDS, WELLMONT WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS, FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH, THE REGION'S LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES. MANY ADDITIONAL COMMUNITY NEEDS EXIST IN OUR REGION. IT IS FISCALLY IMPOSSIBLE FOR A HOSPITAL TO ADDRESS EVERY HEALTH NEED IN A COMMUNITY, WHICH IS WHY THE CHNA PROCESS IS USED TO IDENTIFY AND PRIORITIZE AREAS OF FOCUS. A THOUGHTFUL CHNA EVALUATES OVERALL COMMUNITY HEALTH NEEDS TO DETERMINE WHICH ONES THE HOSPITAL CAN BEST INFLUENCE IN A POSITIVE WAY. CONSIDERATION IS GIVEN TO OTHER ORGANIZATIONS IN THE HOSPITAL'S GEOGRAPHIC AREA THAT ALREADY OFFER SERVICES ADDRESSING SPECIFIC HEALTH NEEDS. IN SOME CASES, IT IS BEST TO SIMPLY SUPPORT AN IDENTIFIED HEALTH NEED THROUGH A FINANCIAL DONATION TO ANOTHER NONPROFIT ORGANIZATION SKILLED IN CERTAIN AREAS: TEEN PREGNANCY, DENTAL HEALTH, FIGHTING HOMELESSNESS, ETC. HOSPITALS ALSO LEND SUPPORT TO OTHER NONPROFIT ORGANIZATIONS BY SERVING ON THEIR BOARDS, COMMITTEES, AND ASSISTING WITH FUNDRAISING EFFORTS. |
| FACILITY 1, WELLMONT HAWKINS CO MEM HOSP,INC - PART V, LINE 13H | BALLAD HEALTH'S FINANCIAL ASSISTANCE POLICY ALLOWS FOR SOME EXCEPTIONS TO STRICTLY ADHERING TO FEDERAL POVERTY GUIDELINES WHEN AWARDING FINANCIAL ASSISTANCE. UNIQUE CIRCUMSTANCES MAY BE WEIGHED AND ASSESSED FOR FINANCIAL ASSISTANCE CONSIDERATION ON A CASE-BY-CASE BASIS. ALSO, THERE ARE SOME SERVICES WHERE FINANCIAL ASSISTANCE MAY BE PROVIDED OUTSIDE OF FEDERAL POVERTY GUIDELINES. THESE ARE NOTED IN BALLAD HEALTH'S FINANCIAL ASSISTANCE POLICY. |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE | FINANCIAL ASSISTANCE APPROVAL CAN APPLY TO AN ASSORTMENT OF PATIENTS SUCH AS THOSE WHO HAVE EXHAUSTED THEIR TENNCARE/MEDICAID BENEFITS, THOSE WHO QUALIFIED FOR TENNCARE/MEDICAID AFTER THE DATE OF SERVICE, DECEASED PATIENTS WITH NO ESTATE OR ASSETS, UNINSURED PATIENTS, AND UNDERINSURED PATIENTS. WHILE BALLAD HEALTH'S QUALIFICATIONS FOR FINANCIAL ASSISTANCE IS BASED ON FEDERAL POVERTY GUIDELINES, ASSET VALUES MAY ALSO BE USED TO DETERMINE ELIGIBILITY. UNIQUE CIRCUMSTANCES MAY BE ASSESSED ON A CASE-BY- CASE BASIS. CHARITY APPROVAL COVERS ALL DATES OF SERVICE FOR THE PATIENT WHEN THEY ARE APPROVED AND THERE IS NO LIMITATION OR CAP ON THE AMOUNT OF CHARITY THAT A PATIENT MAY RECEIVE. BALLAD HEALTH HOSPITALS DO NOT STOP APPROVING FINANCIAL ASSISTANCE FOR PATIENT ACCOUNTS IF A HOSPITAL'S CHARITY WRITEOFFS EXCEED THE HOSPITAL'S CHARITY BUDGET. ALL BALLAD HEALTH HOSPITALS PROVIDE AN UNINSURED DISCOUNT. THE CURRENT UNINSURED DISCOUNT IS 74% FOR WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL, INC. IN ADDITION TO THE UNINSURED DISCOUNT, MANY PATIENTS WILL FURTHER QUALIFY FOR ADDITIONAL FINANCIAL ASSISTANCE. ALL PATIENTS SEEKING FINANCIAL ASSISTANCE MUST SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE AND SUBMIT DOCUMENTS IN SUPPORT OF THE INFORMATION ON THE APPLICATION, UNLESS SPECIFICALLY EXCLUDED PER OUR POLICY GUIDELINES. MEDICAID ELIGIBLE PATIENTS WILL QUALIFY FOR 100% FINANCIAL ASSISTANCE AND NOT BE REQUIRED TO COMPLETE THE REQUIRED DOCUMENTATION WHEN: A) MEDICAID ELIGIBILITY REQUIREMENTS ARE MET AFTER THE SERVICE IS PROVIDED, B) NON-COVERED CHARGES OCCUR ON A MEDICAID ELIGIBLE ENCOUNTER, OR C) BENEFITS HAVE BEEN EXHAUSTED. DECEASED PATIENTS WITH NO ESTATE ALSO QUALIFY FOR 100% FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE DETERMINATIONS MAY BE RETROACTIVE FOR ALL OUTSTANDING BALANCES. IN ADDITION, WE HAVE A NUMBER OF PROGRAMS WITH SPECIAL DISCOUNTS SUCH AS LACTATION CONSULTATION SERVICES, ONCOLOGY TREATMENT REGIMENS, ENROLLMENT IN VARIOUS COMMUNITY PROGRAMS, AND PRESCRIPTION DRUGS FILLED POST-DISCHARGE. |
| PART I, LINE 6A - RELATED ORGANIZATION INFORMATION | DURING FY18, WELLMONT HEALTH SYSTEM COMPLETED A COMMUNITY BENEFIT REPORT FOR ALL OF ITS FACILITIES (INCLUDING HAWKINS COUNTY MEMORIAL HOSPITAL). BELOW ARE THE ORGANIZATIONS INCLUDED IN THE REPORT: - BRISTOL REGIONAL MEDICAL CENTER - HANCOCK COUNTY HOSPITAL - HOLSTON VALLEY MEDICAL CENTER - LONESOME PINE HOSPITAL - MOUNTAIN VIEW REGIONAL MEDICAL CENTER - TAKOMA REGIONAL HOSPITAL - WELLMONT CARDIOLOGY SERVICES - WELLMONT MEDICAL ASSOCIATES - WELLMONT MADISON HOUSE - WELLMONT WEXFORD HOUSE |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | THE COST TO CHARGE RATIO (WORKSHEET 2 "RATIO OF PATIENT CARE COST TO CHARGES") WAS USED TO CALCULATE LINE 7A FINANCIAL ASSISTANCE (CHARITY CARE) COST AND LINE 7B TENNCARE AND MEDICAID LOSSES. LINE 7E COMMUNITY HEALTH IMPROVEMENT INCLUDES COSTS THAT ARE TAKEN DIRECTLY FROM DEPARTMENTAL OPERATING REPORTS OR EXPENSES SPECIFIC TO A COMMUNITY HEALTH EVENT, WITH NO ADDITIONAL OVERHEAD INCLUDED IN THE COST. LINE 7F HEALTH PROFESSIONS EDUCATION IS COMPRISED OF STUDENT INTERNSHIPS (PRIMARILY NURSING, EMT/PARAMETIC AND STUDENTS FROM OTHER ALLIED HEALTH PROGRAMS) WITH SCHOOLS AND PROGRAMS, ALLOWING THEIR HEALTH PROFESSION STUDENTS TO GET HANDS-ON TRAINING IN A HOSPITAL SETTING. |
| PART II - COMMUNITY BUILDING ACTIVITIES | HOSPITAL LEADERS SUPPORT AND ENCOURAGE ALL TEAM MEMBERS TO VOLUNTEER TIME, MONEY AND SKILLS TO COMMUNITY SERVICE PROJECTS AND CHARITABLE ORGANIZATIONS. SENIOR LEADERS AND BOARD MEMBERS SET A POSITIVE EXAMPLE FOR WHCMH TEAM MEMBERS, SERVING VOLUNTARILY ON COMMITTEES AND BOARDS OF LOCAL SERVICE AND NONPROFIT ORGANIZATIONS. SOME ALSO SERVE AS MEMBERS AND CONSULTANTS ON PROFESSIONAL COMMITTEES AND TASK FORCES THAT AFFECT REGIONAL DEVELOPMENT IN HEALTHCARE AND EDUCATION. WE DO NOT CAPTURE COSTS ASSOCIATED WITH TEAM MEMBERS THAT SERVE ON OTHER NONPROFIT BOARDS OR PROVIDE SERVICES TO OTHER NONPROFITS. THE HOSPITAL, IN COLLABORATION WITH AREA HEALTH AGENCIES AND PROVIDERS, MAY OFFER ASSISTANCE WITH COORDINATION, ADVOCACY, PROVIDE SPACE, OR CONTRIBUTE SUPPLIES TO SUPPORT GROUPS FOR THEIR PROGRAM ACTIVITIES THAT SERVE TO ASSIST SPECIAL POPULATIONS WITHIN OUR AREA. MOST OF THESE ORGANIZATIONS WORK TO IMPROVE THE LIVES OF COMMUNITY MEMBERS THAT HAVE LIMITED, OR NO, FINANCIAL RESOURCES. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | SELF-PAY BALANCES INCLUDE ACCOUNTS AFTER PAYMENTS AND CONTRACTUAL ADJUSTMENTS (DISCOUNTS) HAVE BEEN APPLIED FROM ALL THIRD-PARTY PAYERS SUCH AS MEDICARE, TENNCARE, COMMERCIAL INSURERS, AND OTHERS - GENERALLY LEAVING THE PATIENT RESPONSIBLE FOR ANY REMAINING DEDUCTIBLE AND/OR CO-PAYMENT. OTHER SELF-PAY ACCOUNTS ARE FROM PATIENTS WITH NO INSURANCE OR OTHER THIRD-PARTY COVERAGE. PATIENTS THAT HAVE NO INSURANCE AND ARE INELIGIBLE FOR ANY GOVERNMENT ASSISTANCE PROGRAM RECEIVED A 76% DISCOUNT THROUGH FEBRUARY 1, 2018, AT WHICH TIME THE UNINSURED DISCOUNT WAS ADJUSTED TO 74%. THE PREVAILING DISCOUNT RATE IS CALCULATED BASED ON STATE OF TENNESSEE REGULATIONS. MANY SELF-PAY PATIENTS WILL FURTHER QUALIFY FOR FINANCIAL ASSISTANCE (SOMETIMES REFERRED TO AS CHARITY CARE) IF THEY PROVIDE THE FINANCIAL INFORMATION WE NEED TO DEEM THEM ELIGIBLE. AFTER THE NORMAL COLLECTION PROCESS HAS INDICATED AN ACCOUNT IS UNCOLLECTIBLE, WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL, INC. WRITES THE ACCOUNT OFF TO BAD DEBT. THE HOSPITAL'S OVERALL SELF-PAY ACCOUNTS RECEIVABLE BALANCE IS EVALUATED ON AN ONGOING BASIS TO EVALUATE THE AGE OF ACCOUNTS RECEIVABLE, HISTORICAL WRITE-OFFS AND RECOVERIES AND ANY UNUSUAL INSTANCES (SUCH AS LOCAL, REGIONAL OR NATIONAL ECONOMIC CONDITIONS) WHICH AFFECT THE COLLECTIVITY OF RECEIVABLES. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | BALLAD HEALTH'S AUDITED FINANCIAL STATEMENTS INCLUDE A FOOTNOTE ON PAGES 13-14 THAT DESCRIBES BAD DEBT. WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL, INC. IS INCLUDED IN THE JUNE 30, 2018 AUDITED FINANCIAL STATEMENTS OF BALLAD HEALTH. THE AUDITED FINANCIAL STATEMENTS ARE FOR THE FIVE MONTHS ENDING AFTER THE FEBRUARY 1, 2018 MERGER OF WELLMONT HEALTH SYSTEM AND MOUNTAIN STATES HEALTH ALLIANCE (ATTACHED). |
| PART III, LINE 8 - MEDICARE EXPLANATION | MEDICARE ALLOWABLE COSTS ARE REPORTED USING WHCMH'S FILED MEDICARE COST REPORTS (C/R). THE C/R USES A COST TO CHARGE RATIO BASED ON A STEP-DOWN ALLOCATION METHODOLOGY. IN CARING FOR THE PATIENT, THERE ARE SEVERAL SERVICES THAT ARE CONSIDERED NON-ALLOWABLE SUCH AS TRANSPORTATION OF A PATIENT AND COMFORT ITEMS THAT INCLUDE A TELEVISION AND A TELEPHONE. THE RECRUITMENT OF PHYSICIANS ARE NON-ALLOWED COSTS BY THE MEDICARE PROGRAM EVEN THOUGH PHYSICIANS ARE RECRUITED BASED ON DOCUMENTED COMMUNITY NEED AND TO FEDERALLY RECOGNIZED MEDICALLY UNDERSERVED AREAS. A PORTION OF THE BAD DEBT ASSOCIATED WITH THE CARE OF THE PATIENT IS NOT AN ALLOWED COST BY MEDICARE, LEAVING THE HOSPITAL TO ABSORB THE LOSS. MEDICARE LOSSES, INCLUDING SOME NON-ALLOWABLE COSTS SUCH AS THOSE NOTED ABOVE, SHOULD BE COUNTED AS A COMMUNITY BENEFIT AS THIS IS THE COST OF CARE FOR SERVING THE AGING POPULATION. WHILE WE AGREE THAT COSTS SUCH AS MARKETING TO ATTRACT PATIENTS AND LOBBYING ARE REASONABLE TO EXCLUDE, IT DOES NOT SEEM REASONABLE TO EXCLUDE RECRUITMENT OF PHYSICIANS AND BASIC ITEMS SUCH AS A TELEVISION AND PHONE IN PATIENT ROOMS. WE BELIEVE MEDICARE LOSSES SHOULD BE ALLOWED AS A REPORTABLE COMMUNITY BENEFIT, SIMILAR TO GOVERNMENTAL PROGRAMS SUCH AS MEDICAID. AS A PARTICIPATING PROVIDER IN THE MEDICARE PROGRAM, HOSPITALS ARE REQUIRED TO PROVIDE THE FULL REGIMEN OF CARE FOR THE MEDICARE POPULATION. THERE ARE A NUMBER OF CARE REGIMENS THAT ARE COMPENSATED BY THE MEDICARE PROGRAM AT LEVELS BELOW COST. THEREFORE, IT IS ONLY LOGICAL TO ALLOW HOSPITALS TO REPORT THESE UNCOMPENSATED SERVICES AS A COMMUNITY BENEFIT. BY MAKING THIS CHANGE, NONPROFIT PROVIDERS WILL BE ENCOURAGED TO CONTINUE IMPORTANT CARE DELIVERY MODELS FOR OUR AGING POPULATION IN SPITE OF THE FACT IT MAY BE ECONOMICALLY INJURIOUS. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL, INC. EXAMINES THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES BY CONDUCTING PHYSICIAN NEEDS ASSESSMENTS FOR ITS HOSPITALS. AS PART OF THIS EFFORT, WELLMONT REVIEWS ITS SERVICE AREA AND DEMOGRAPHICS, EXAMINES PHYSICIAN DEMOGRAPHICS AND CONDUCTS FOCUS GROUPS. IT MAKES A DETERMINATION OF PHYSICIAN NEED WHILE CALCULATING ITS PHYSICIAN SURPLUSES AND DEFICITS AND HIGHLIGHTING ITS RECRUITMENT PRIORITIES AND PLANS. WELLMONT ANNUALLY DETERMINES ITS PRIMARY, SECONDARY AND TERTIARY MARKETS THROUGH THE USE OF COUNTY-BY-COUNTY ANALYSIS TO IDENTIFY THE FOLLOWING CUSTOMER GROUPS: PATIENTS AND POTENTIAL PATIENTS, COMMUNITY/EMPLOYER GROUPS AND LOCAL PHYSICIANS. THE HEALTH SYSTEM ALSO RELIES ON THE EXPERTISE OF CONSULTANTS TO PERIODICALLY REVIEW ALL FACETS OF OPERATIONS AND MAKE RECOMMENDATIONS FOR CHANGES. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | THE HOSPITAL COMMUNICATES WITH AND PROVIDES EDUCATION TO OUR PATIENTS THROUGH VARIOUS AVENUES REGARDING GOVERNMENTAL ASSISTANCE PROGRAMS AND HOSPITAL FINANCIAL ASSISTANCE. VARIOUS EDUCATIONAL AND APPLICATION DOCUMENTS RELATED TO OBTAINING FINANCIAL ASSISTANCE ARE WIDELY AVAILABLE AND ALL DOCUMENTS ARE AVAILABLE ON THE BALLAD HEALTH WEBSITE. PRINTED FINANCIAL ASSISTANCE EDUCATIONAL MATERIALS ARE PART OF EACH REGISTRATION PACKET AND POSTERS ARE DISPLAYED IN HIGHLY VISIBLE AREAS OF THE HOSPITAL. OUR FINANCIAL ASSISTANCE POLICY AND DOCUMENTS ARE AVAILABLE IN OUR EMERGENCY DEPARTMENT AND ADMITTING AREAS. WE ARE ALSO HAPPY TO MAIL ALL DOCUMENTS TO PATIENTS. WE OFFER A PLAIN LANGUAGE SUMMARY AND ALL OF OUR DOCUMENTS ARE AVAILABLE IN ENGLISH AND SPANISH. FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE DURING PRE-REGISTRATION, REGISTRATION AND/OR DURING FINANCIAL COUNSELING. WE OFFER GOVERNMENTAL PROGRAM ELIGIBILITY REPRESENTATIVES TO ASSIST PATIENTS IN SECURING ELIGIBILITY FOR TENNCARE OR MEDICAID, FEDERAL DISABILITY AND OTHER GOVERNMENTAL ASSISTANCE PROGRAMS. ADDITIONALLY, IF A PATIENT OR COMMUNITY RESIDENT EXPRESSES AN INTEREST IN THE ACA-HEALTHCARE EXCHANGE, OUR REPRESENTATIVES HAVE THE QUALIFICATIONS AND EXPERIENCE TO ASSIST THEM THROUGH THE ENTIRE PROCESS. OUR FINANCIAL COUNSELORS OFFER FINANCIAL ASSISTANCE APPLICATIONS TO PATIENTS WHO DO NOT QUALIFY FOR GOVERNMENTAL ASSISTANCE PROGRAMS AND ARE UNABLE TO PAY FOR SOME OR ALL OF THEIR HEALTHCARE. ALL PATIENT BILLING STATEMENTS HAVE VERBIAGE DISCUSSING FINANCIAL ASSISTANCE ALONG WITH CONTACT INFORMATION. OUR LAST LETTER TO THE PATIENT DISPLAYS THE PLAIN LANGUAGE SUMMARY. IN ALL ORAL CORRESPONDENCES WITH A PATIENT, IF IT IS IDENTIFIED THE PATIENT CANNOT MEET PAYMENT REQUIREMENTS ON THEIR ACCOUNT, FINANCIAL ASSISTANCE IS DISCUSSED AS AN OPTION. APPLICANTS ARE NOTIFIED OF FINANCIAL ASSISTANCE DETERMINATION IN WRITING. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL, INC.'S PRIMARY SERVICE AREA IS HAWKINS AND HANCOCK COUNTIES OF TENNESSEE. WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL, INC. IS THE ONLY HOSPITAL IN HAWKINS COUNTY AND ITS SISTER FACILITY, HANCOCK COUNTY HOSPITAL IS THE ONLY HOSPITAL IN HANCOCK COUNTY. ACCORDING TO U.S. CENSUS BUREAS ESTIMATES, HAWKINS COUNTY HAS A POPULATION OF 56,530 AND HANCOCK COUNTY HAS A POPULATION OF 6,549. THE LATEST CENSUS BUREAU DATA ESTIMATES THE MEDIAN AGE OF RESIDENTS OF HAWKINS COUNTY IS 44.2 AND HANCOCK COUNTY IS 44.6 WHICH IS OLDER THAN THE MEDIAN AGE OF 38.6 IN TENNESSEE. 20.5% OF HAWKINS COUNTY RESIDENTS ARE 65 OR OLDER COMPARED TO 16% FOR THE STATE. THE POPULATION PROJECTIONS FOR HAWKINS COUNTY OVER THE NEXT FIVE YEARS INDICATE THAT THE CONTY WILL LIKELY EXPERIENCE LITTLE TO NO POPULATION GROWTH OVERALL. HOWEVER, THE AGE 65+ POPULATION FOR HAWKINS COUNTY IS PROJETED TO EXPERIENCE THE MOST POPULTON CHANGE OVER THE NEXT FIVE YEARS. THE AGING POPLUATION OF THE COUNTY PRESENTS OPPORTUNITIES FOR EARLIER IDENTIFICATION AND BETTER MANAGEMENT OF HEALTH CONDITIONS THAT OFTENTIMES AFFECT ELDERLY POPLUATIONS. THE BUREAU ESTIMATES HAWKINGS COUNTY MEDIAN HOUSEHOLD INCOME AT 38,728 AND HANCOCK COUNTY'S MEDIAN HOUSEHOLD INCOME AT 29,619 COMPARED TO THE STATE OF TENNESSEE'S MEDIAN INCOME OF 48,708. 27% OF HANCOCK COUNTY'S CHILDREN LIVE IN POVERTY COMPARED TO 23% STATEWIDE. HAWKINS COUNTY IS ALMOST 58% RURAL COMPARED WITH THE STATEWIDE RURAL RATE OF 33.6%. THIS IS A SIGNIFICANT CONTRIBUTING FACTOR IN INFLUENCING HEALTH OUTCOMES IN A POPULATION. MANY RURAL RESIDENTS MUST TRAVEL A GREATER DISTANCE TO ACCESS DIFFERENT POINTS OF THE HEALTH CARE DELIVERY SYSTEM; HOWEVER, DUE TO GEOGRAPHIC DISTANCE, SOMETIMES EXTREME WEATHER CONDITIONS, LACK OF PUBLIC TRANSPORTATION AND CHALLENGING ROADS, RURAL RESIDENTS MAY BE LIMITED, AND IN SOME INSTANCES, EVEN PROHIBITED FROM ACCESSING HEALTH CARE SERVICES. MORE THAN 50% OF VEHICLE CRASH-RELATED FATALITIES OCCUR IN RURAL AREAS, EVEN THOUGH LESS THAN ONE-THIRD OF MILES TRAVELED IN A VEHICLE OCCUR THERE. AND THERE IS AN ADDITIONAL 22% RISK OF INJURY-RELATED DEATHS IN RURAL COMMUNITIES. WHILE OUR AREA HAS GENERALLY UNFAVORABLE HEALTH STATISTICS, THERE ARE FAR FEWER PRIMARY CARE PHYSICIANS PER RESIDENT IN OUR COUNTY THAN THE STATE'S AVERAGE. OUR COUNTY'S RATIO OF POPULATION TO PRIMARY CARE PHYSICIANS IS 3,540:1 COMPARED TO THE STATE'S AVERAGE OF 1,390:1. IN OTHER WORDS, WE HAVE 155% MORE RESIDENTS PER PHYSICIAN THAN THE OVERALL STATE RATE. OUR COUNTY'S RATIO OF POPULATION OF MENTAL HEALTH PROVIDERS IS 6,270:1 COMPARED TO THE STATE'S AVERAGE OF 700:1. THIS IS ALMOST 800% MORE RESIDENTS PER MENTAL HEALTH PROVIDER THAN THE OVERALL STATE RATE. RECRUITING PHYSICIANS TO RURAL AREAS IS OFTEN CHALLENGING DUE TO A MYRIAD OF FACTORS, SUCH AS GEOGRAPHY, ECONOMICS, CULTURE AND EDUCATION. GEOGRAPHICALLY, RURAL COMMUNITIES ARE OFTEN FAR REMOVED FROM SUBURBAN AND URBAN CENTERS THAT PROVIDE ACCESS TO EDUCATION, CULTURAL AND ECONOMIC OPPORTUNITIES. THESE LIMITATIONS INFLUENCE THE RELOCATION DECISION OF THE PHYSICIAN CANDIDATE AND HIS/HER SPOUSE/ CHILDREN TO LOCATE TO A RURAL AREA. A NUMBER OF FACTORS CONTRIBUTE TO A UNIQUE AND CHALLENGING ENVIRONMENT THAT INFLUENCE OVERALL HEALTH STANDING IN OUR COUNTY. ACCORDING TO THE ROBERT WOOD JOHNSON FOUNDATION'S COUNTY HEALTH RANKINGS, 33% OF THE ADULTS IN HAWKING'S OUNTY ARE OBESE. OBESITY INCREASES THE RISK FOR MANY HEALTH CONDITIONS SUCH AS CORONARY HEART DISEASE, TYPE 2 DIABETES, HYPERTENSION, STROKE, CANCER, SLEEP APNEA AND RESPIRATORY PROBLEMS, AND OSTEOARTHRITIS. EVIDENCE INDICATES PHYSICAL ACTIVITY, INDEPENDENT OF ITS EFFECT ON WEIGHT, HAS SUBSTANTIAL BENEFITS FOR HEALTH. OUR COUNTY'S INACTIVITY RATE OF 33% IS 23% HIGHER THAN THE STATEWIDE RATE AND RESIDENT'S ACCESS TO EXERCISE OPPORTUNITIES IS 32% LESS THAN THE STATE. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | WHCMH IS DEDICATED TO OPERATING EFFICIENTLY SO THAT WASTE IS MINIMIZED. WHCH'S LEADERSHIP REMAINS MINDFUL OF MANAGING LIMITED RESOURCES SO THAT ADEQUATE FACILITIES AND EQUIPMENT ARE AVAILABLE FOR THE CARE OF OUR PATIENTS. SURPLUS FUNDS ARE INVESTED INTO IMPROVING TREATMENT OPTIONS FOR OUR PATIENTS THROUGH NEW TECHNOLOGIES, RECRUITING PHYSICIANS AND TRAINED STAFF IN SHORTAGE AREAS, AND IMPROVING OUR FACILITIES. VARIOUS CHECKS AND BALANCES ARE ESTABLISHED TO ENSURE THAT EXPENDITURES FOR OPERATING EXPENSES AND CAPITAL COSTS ARE REASONABLE AND NECESSARY. WHCMH SERVES AS A TRAINING SITE FOR MANY TYPES OF HEALTH PROFESSIONS: EMT/PARAMEDICS, OT/PT AND OTHER ALLIED HEALTH PROFESSIONS. STUDENTS FROM COLLEGES AND PROGRAMS RECEIVE TRAINING AND EXPERIENCE IN OUR HOSPITALS. WE DEVOTE RESOURCES TO HEALTH CONFERENCES FOR LOCAL HEALTH PROFESSIONALS AND OFFER OTHER PROGRAMS FOCUSED ON IMPROVING THE HEALTH OF OUR RESIDENTS. WHILE WE OPERATE IN A PREDOMINANTLY LOW-INCOME, RURAL AREA, WE CONTINUE TO OFFER SERVICES THAT OPERATE AT A LOSS BECAUSE HAWKIN'S COUNTY RESIDENTS WOULD OTHERWISE NEED TO LEAVE THEIR HOME TOWN OR COUNTY TO RECEIVE NEEDED CARE. THE MEDICAL STAFF OF WHCMH IS OPEN TO ALL QUALIFIED PHYSICIANS. |
| PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM | WHCMH IS A 50-BED, ACUTE-CARE FACILITY AND ONE OF THE HOSPITALS WITHIN THE BALLAD HEALTH SYSTEM. BALLAD HEALTH OPERATES A FAMILY OF 21 HOSPITALS, INCLUDING THREE TERTIARY CARE FACILITIES, A DEDICATED CHILDREN'S HOSPITAL, COMMUNITY HOSPITALS, THREE CRITICAL ACCESS HOSPITALS, A BEHAVIORAL HEALTH HOSPITAL, AN ADDICTION TREATMENT FACILITY, LONG-TERM CARE FACILITIES, HOME CARE AND HOSPICE SERVICES, RETAIL PHARMACIES, OUTPATIENT SERVICES AND A COMPREHENSIVE MEDICAL MANAGEMENT CORPORATION. PATIENTS BENEFIT FROM WCMH'S AFFILIATION WITH A HEALTHCARE SYSTEM WHERE THEY CAN BE EFFICIENTLY MOVED ALONG AN INTEGRATED, COMPREHENSIVE CONTINUUM OF CARE AS THEIR HEALTH STATUS DICTATES. IF NEEDED, PATIENTS CAN BE MOVED TO ONE OF BALLAD HEALTH'S TERTIARY CARE FACILITIES PROVIDING ADVANCED TREATMENT OPTIONS. |
| PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT | TENNESSEE, VIRGINIA |
| ADDITIONAL INFORMATION | BALLAD HEALTH IS REQUIRED TO REPORT COMMUNITY BENEFIT ESTIMATES ON A QUARTERLY BASIS WITH THE STATES OF TENNESSEE AND VIRGINIA. THE REPORTING INCLUDES ALL OF BALLAD'S HOSPITAL ORGANIZATIONS AND IS REPORTED USING IRS FORM 990, SCHEDULE H COMMUNITY BENEFIT INSTRUCTIONS. BALLAD OPERATES UNDER A CERTIFICATE OF PUBLIC ADVANTAGE (COPA) IN TENNESSEE AND A COOPERATIVE AGREEMENT (CA) IN VIRGINIA AS OBLIGATED BY AGREEMENTS BETWEEN BALLAD AND THE TWO STATES TO ALLOW WELLMONT HEALTH SYSTEM AND MOUNTAIN STATES HEALTH ALLIANCE TO MERGE. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|
| BARTON HOVE RETIRED 1312018 | ||||||
| PRESIDENT/WHS CEO | $817,290 | $391,085 | $11,551 | $27,695 | $21,864 | $1,269,485 |
| GARY MILLER | ||||||
| TREAS/SR VP COPA | $348,799 | $170,792 | $1,283 | $16,306 | $10,791 | $547,971 |
| TODD DOUGAN (END 4302018) | ||||||
| SEC/FIN INTEGRATION | $344,429 | $143,894 | $95 | $15,519 | $21,208 | $525,145 |
| REBECCA BECK | ||||||
| PRESIDENT-WHCMH&HCH | $152,172 | $28,106 | $210 | $9,310 | $15,794 | $205,592 |
| REGINA DAY | ||||||
| ADMIN HCMH & HCH | $102,082 | $33,432 | $33,452 | $20 | $274 | $169,260 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4A | (CONT'D) IN FISCAL YEAR 2018, WE PROVIDED SERVICES TO 924 INPATIENTS, HAD 169 INPATIENT AND OUTPATIENT SURGICAL CASES, AND HAD 14,603 EMERGENCY ROOM VISITS. WE ARE MINDFUL OF OUR RESPONSIBILITIES AS ONE OF HAWKINS COUNTY'S LARGEST EMPLOYERS. HUNDREDS OF FAMILIES COUNT ON US FOR THEIR LIVELIHOODS. OUR AREA RELIES ON US AS A DRIVER OF ECONOMIC DEVELOPMENT. IT IS OUR DUTY AS A CORPORATE CITIZEN TO SUPPORT THOSE ENDEAVORS AND CAUSES THAT IMPROVE THE QUALITY OF LIFE IN OUR REGION. AND WE ALSO RECOGNIZE IT IS OUR RESPONSIBILITY TO CARE FOR THOSE IN NEED - REGARDLESS OF THEIR ABILITY TO PAY. WHCMH SERVES AS A CLINICAL TRAINING FACILITY FOR HEALTH PROFESSION STUDENTS. WE DEDICATE STAFF TO WORK WITH REGIONAL COLLEGES AND PROGRAMS TO COORDINATE PLACEMENT OF HEALTHCARE PROFESSION STUDENTS AS PART OF THEIR EDUCATIONAL CURRICULUM. IN ADDITION TO CLINICAL TRAINING, THE HEALTH CARE STUDENTS ARE REQUIRED TO HAVE ORIENTATION AND COMPUTER TRAINING. PARTICIPATING IN THE HANDS-ON TRAINING THIS YEAR WERE OT/PT, EMT/PARAMEDIC AND OTHER ALLIED HEALTH DISCIPLINE STUDENTS. THE COST TO THE HOSPITAL WAS APPROXIMATELY 30,000 TO PROVIDE TRAINING TO 22 PARTICIPANTS. WE SUPPORT AND ENCOURAGE OUR EMPLOYEES TO GIVE THEIR TIME TO AREA NOT-FOR- PROFIT ORGANIZATIONS, WHICH INCLUDED THE AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY, THE ROGERSVILLE HERITAGE ASSOCIATION, CIVIC GROUPS SUCH AS KIWANIS AND ROTARY, VARIOUS UNITED WAY AGENCIES AND THE ROGERSVILLE AREA CHAMBER OF COMMERCE AND ITS PROGRAMS. MANY OF OUR EMPLOYEES ALSO SERVE IN COMMUNITY RESCUE SQUADS. THE BEST WAY TO KEEP OUR COMMUNITIES HEALTHY IS TO PROVIDE THEM WITH THE LATEST INFORMATION ABOUT THEIR HEALTH. WE STRIVE TO PROVIDE INFORMATION ABOUT EVERYTHING FROM DISEASE AND INJURY PREVENTION TO THE LATEST TREATMENTS AND TECHNOLOGIES AVAILABLE TO COPING WITH DISEASE AND ITS SYMPTOMS. CHARITY CARE: WHILE REIMBURSEMENT FOR HEALTHCARE SERVICES IS CRITICAL TO THE OPERATION AND SUSTAINABILITY OF THE HOSPITAL, WHCMH RECOGNIZES ITS OBLIGATION TO PROVIDE CARE TO INDIVIDUALS WHO CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, INCLUDING EMERGENCY CARE. ALL PATIENTS ARE ACCEPTED REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT IS APPROVED FOR FINANCIAL ASSISTANCE (CHARITY) WHEN THEY MEET THE ESTABLISHED POLICIES OF BALLAD HEALTH AND GUIDELINES OUTLINED BY THE FEDERAL GOVERNMENT. HOWEVER, FINANCIAL ASSISTANCE DECISIONS ARE NOT SOLELY BASED ON INCOME. UNIQUE FINANCIAL CIRCUMSTANCES ARE WEIGHED WITH VERIFIED PATIENT ASSETS WHICH CAN DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY. IT IS NOT UNTIL AFTER VERIFICATION OF INCOME AND ASSETS THAT A DECISION REGARDING THE AMOUNT OF FINANCIAL ASSISTANCE CAN BE MADE. IN FISCAL YEAR 2018, WHCMH INCURRED A LOSS OF 1,525,111 ATTRIBUTABLE TO THE PROVISION OF CHARITY CARE. TENNCARE/MEDICAID: WHCMH PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, SUCH AS TENNCARE (TENNESSEE RESIDENTS) AND MEDICAID (VIRGINIA RESIDENTS). WHCMH INCURRED A LOSS OF 1,937,487 PROVIDING CARE TO THIS POPULATION OF PATIENTS DURING THE YEAR. UNINSURED DISCOUNT: UNINSURED PATIENTS RECEIVED A 76% PERCENT DISCOUNT THROUGH OCTOBER 31, 2018, AT WHICH TIME THE UNINSURED DISCOUNT DECREASED TO 74%. CERTAIN ELECTIVE PROCEDURES ARE NOT ELIGIBLE FOR THE UNINSURED DISCOUNT. THIS UNINSURED DISCOUNT IS CALCULATED EACH YEAR IN ACCORDANCE WITH TENNESSEE REGULATIONS AND WITHOUT REGARD TO A PATIENT'S INCOME OR ASSETS. THE APPROXIMATE COST OF THIS DISCOUNT IN FY18, USING THE HOSPITAL'S COST TO CHARGE RATIO, WAS 363,026. THE HOSPITAL PROVIDES MEETING SPACE FOR THE MONTHLY MEETINGS OF ALCHOLICS ANNONYMOUS. |
| FORM 990, PAGE 6, PART VI, LINE 6 | WELLMONT HEALTH SYSTEM IS WHCMH'S SOLE MEMBER. THE BOARD OF DIRECTORS OF BALLAD HEALTH, WELLMONT'S PARENT ORGANIZATION, SERVES AS WELLMONT'S BOARD OF DIRECTORS AND IS RESPONSIBLE FOR APPOINTING THE DIRECTORS OF WHCMH'S BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 7A | FOLLOWING THE MERGER OF WHCMH'S SOLE MEMBER, WELLMONT HEALTH SYSTEM, AND MOUNTAINS STATES HEALTH ALLIANCE IN FEBRUARY 2018 TO FORM BALLAD HEALTH, THE NEWLY APPOINTED BALLAD HEALTH BOARD OF DIRECTORS ASSUMED BOARD RESPONSIBILITIES FOR WELLMONT AND MOUNTAIN STATES. BOTH WELLMONT AND MOUNTAIN STATES REMAIN SEPARATE LEGAL ENTITIES. |
| FORM 990, PAGE 6, PART VI, LINE 7B | CERTAIN DECISIONS OF THE BOARD ARE, PURSUANT TO CHARTER, SUBJECT TO APPROVAL OF THE MEMBERS. THESE DECISIONS INCLUDE: DISSOLUTION OF THE CORPORATION, MERGER OF THE CORPORATION, NON-ORDINARY COURSE OF BUSINESS SALE OF ASSETS, ETC. NO ORDINARY, DAY-TO-DAY DECISIONS ARE SUBJECT TO MEMBER APPROVAL. |
| FORM 990, PAGE 6, PART VI, LINE 9 | BARTON HOVE (RETIRED 1/31/2018) |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE ADMINISTRATOR OF WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL, INC. REVIEWED THE WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL, INC. FORM 990 WITH THE WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL, INC. BOARD OF DIRECTORS PRIOR TO FILING. THE RETURN WAS MADE AVAILABLE TO EACH BOARD MEMBER IN AN ELECTRONIC FORMAT PRIOR TO THE REVIEW. |
| FORM 990, PAGE 6, PART VI, LINE 12C | WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL, INC. IS PART OF THE NEWLY FORMED BALLAD HEALTH HEALTHCARE SYSTEM FORMED WHEN WELLMONT HEALTH SYSTEM AND MOUNTAIN STATES HEALTH ALLIANCE MERGED IN FEBRUARY 2018. BALLAD HEALTH HAS A CONFLICT OF INTEREST POLICY FOR ALL MEMBERS OF THE BOARD OF DIRECTORS, THE EXECUTIVE CHAIR/PRESIDENT, EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, AND VICE PRESIDENTS, AND APPLIES TO ALL BALLAD HEALTH ORGANIZATIONS. ALL PERSONS COVERED BY THIS POLICY ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM ON AN ANNUAL BASIS. SHOULD A CONFLICT ARISE, IT IS THE RESPONSIBILITY OF THE CONFLICTED INDIVIDUAL TO UPDATE HIS OR HER DISCLOSURE IMMEDIATELY. ALL MEETINGS OF THE BOARD OR BOARD COMMITTEES HAVE A STANDING AGENDA ITEM FIRST ON THE AGENDA TITLED "CONFLICTS OF INTEREST". IF A MEMBER OF THE BOARD OR BOARD COMMITTEE HAS A CONFLICT OF INTEREST INVOLVING ANY ISSUE ON THE BOARD AGENDA, HE OR SHE MUST DECLARE THE CONFLICT OF INTEREST DURING THE PERIOD ALLOTTED FOR DISCLOSURE. IF ANY ISSUE ARISES DURING A MEETING IN WHICH THE BOARD MEMBER HAS A CONFLICT OF INTEREST, HE OR SHE MUST IMMEDIATELY DECLARE THE CONFLICT. WHILE EACH MEMBER OF THE BOARD OR BOARD COMMITTEES ARE RESPONSIBLE FOR DISCLOSING CONFLICTS OF INTEREST, IT IS ALSO THE RESPONSIBILITY OF ANY BOARD MEMBER AWARE OF A CONFLICT WHICH HAS NOT BEEN DISCLOSED TO ENSURE THE BOARD IS MADE AWARE. THE PRESIDING OFFICER OF A BOARD OR BOARD COMMITTEE MEETING MAY ASK A CONFLICTED MEMBER TO EXCUSE THEMSELVES FROM THE MEETING DURING THE DISCUSSION RELATED TO THE ISSUE WITH WHICH THE CONFLICT OF INTEREST APPLIES. UNDER NO CIRCUMSTANCES SHALL A MEMBER VOTE ON A MATTER THAT GIVES RISE TO A POTENTIAL CONFLICT. |
| FORM 990, PAGE 6, PART VI, LINE 15A | ON AN ANNUAL BASIS, BALLAD HEALTH'S HUMAN RESOURCES (HR) DEPARTMENT EVALUATES COMPENSATION FOR ALL EXECUTIVES AT A POSITION LEVEL OF ASSISTANT VICE PRESIDENT AND ABOVE. THE REVIEW INCLUDES WHCMH'S BOARD PRESIDENT AND THE ORGANIZATION'S ADMINISTRATOR. HR'S EVALUATION IS BASED ON MARKET DATA OBTAINED FROM INDEPENDENT THIRD-PARTY CONSULTANTS FOR POSITIONS WITH SIMILAR RESPONSIBILITIES AT SIMILARLY SITUATED ORGANIZATIONS. BASED ON THIS COMPARABILITY DATA, BALLAD HEALTH'S PRESIDENT & CEO EVALUATES THE DATA AND SUBMITS HIS RECOMMENDATIONS TO BALLAD HEALTH'S BOARD OF DIRECTORS FOR THEIR FINAL REVIEW AND APPROVAL. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SIMILAR TO WHCMH'S BOARD PRESIDENT AND THE ORGANIZATION'S ADMINISTRATOR, WHCMH'S OTHER OFFICERS RECEIVE COMPENSATION THAT COMPLIES WITH BALLAD HEALTH'S SALARY POLICY. THEIR PAY IS SET AT A MARKET PERCENTILE SPECIFIC TO THEIR POSITIONS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST TO THE APPROPRIATE PARTIES REQUESTING THEM. FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM. |
| FORM 990, PART IX, LINE 11G | FEES FOR SERVICES 116,408 38,520 0 INFUSION CENTER 95,922 0 0 PHARMACY 36,513 0 0 SUPPORT SERVICES FROM PARENT 0 1,390,530 0 PHYSICIAN FEES 625,488 0 0 LABORATORY SERVICES 1,012,201 0 0 RADIOLOGY 303,895 0 0 ENVIRONMENTAL SERVICES 115,500 0 0 REHAB AND SPINE 36,060 0 0 ENGINEERING 0 322,713 0 TOTAL 2,341,987 1,751,763 0 |
| FORM 990, PART XI, LINE 9 | CAPITAL CONTRIBUTION FROM PARENT 2,945,090 ELIMINATION OF INTERCOMPANY REC/PAY -1,591,180 EMPLOYER PROVIDED PARKING - NOT ON BOOKS -3,939 TOTAL 1,349,971 |
| FORM 990, PAGE 12, PART XII, LINE 2C | BALLAD HEALTH (BALLAD) IS A TAX-EXEMPT ENTITY AND THE PARENT CORPORATION OF BOTH MOUNTAIN STATES HEALTH ALLIANCE (MSHA) AND WELLMONT HEALTH SYSTEM (WHS). THE TWO HEALTHCARE SYSTEMS CAME TOGETHER ON FEBRUARY 1, 2018 AS A RESULT OF A MERGER APPROVED BY BOTH TENNESSEE AND VIRGINIA DEPARTMENTS OF HEALTH. THE INDIVIDUALS SERVING AS THE BOARD OF DIRECTORS OF BALLAD ALSO SERVE AS THE BOARD OF DIRECTORS OF MSHA AND WHS. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF BALLAD INCLUDE MSHA, WHS AND THEIR SUBSIDIARIES AND AFFILIATES WHICH WERE PREVIOUSLY INCLUDED IN EITHER MSHA OR WHS AUDITED CONSOLIDATED FINANCIAL STATEMENTS. BALLAD HAS AN AUDIT COMMITTEE WHICH ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. FORM 990 - ADDITIONAL INFORMATION FY18 FORM 990 HAS NUMEROUS REPORTING CHANGES FROM PRIOR YEAR RETURNS. WE BELIEVE THESE CHANGES ARE NECESSARY TO BETTER REFLECT THE ORGANIZATION'S ACTIVITY. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (22 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| WELLMONT HEALTH SYSTEM | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621636465 | HOSP. SYS. | TN | 501C3 | 3 | BALLAD | false |
| TAKOMA REGIONAL HOSPITAL INC | ||||||||||
| 401 TAKOMA AVENUE | GREENEVILLE | TN | 37743 | 510603966 | HOSPITAL | TN | 501C3 | 3 | WHS | false |
| TAKOMA REGIONAL HOSPITAL FDN INC | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 471334302 | FUNDRAISER | TN | 501C3 | 7 | WHS | false |
| WELLMONT CARDIOLOGY SERVICES | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 263557623 | MED. SERV. | TN | 501C3 | 10 | WHS | false |
| WELLMONT MEDICAL ASSOCIATES INC | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 270898372 | MED. SERV. | TN | 501C3 | 7 | WHS | false |
| WELLMONT SLEEP SERVICES | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 273777167 | MED. SERV. | TN | 501C3 | 3 | WHS | false |
| WELLMONT FOUNDATION INC | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 581594191 | FUNDRAISER | TN | 501C3 | 7 | WHS | false |
| WELLMONT MADISON HOUSE | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621308216 | ASST. LIV. | TN | 501C3 | 10 | WHS | false |
| WELLMONT WEXFORD HOUSE | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 581859039 | NSG. HOME | TN | 501C3 | 10 | WHS | false |
| WELLMONT IMAGING SERVICES INC | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 861103148 | HEALTHCARE | TN | 501C3 | 12A | WHS | false |
| MOUNTAIN STATES HEALTH ALLIANCE | ||||||||||
| 303 MED TECH PARKWAY SUITE 220 | JOHNSON CITY | TN | 37604 | 620476282 | HOSP. SYS. | TN | 501C3 | 3 | BALLAD | false |
| MOUNTAIN STATES FOUNDATION | ||||||||||
| 2335 KNOB CREEK ROAD SUITE 101 | JOHNSON CITY | TN | 37604 | 581418862 | FUNDRAISER | TN | 501C3 | 12A | MSHA | false |
| MSHA AUXILIARY | ||||||||||
| 400 N STATE OF FRANKLIN ROAD | JOHNSON CITY | TN | 37604 | 581418345 | SUPP. ORG | TN | 501C3 | 12A | MSHA | false |
| SMYTH COUNTY COMMUNITY HOSPITAL | ||||||||||
| 245 MEDICAL PARK DRIVE | MARION | VA | 24354 | 540794913 | HOSPITAL | VA | 501C3 | 3 | MSHA | false |
| NORTON COMMUNITY HOSPITAL | ||||||||||
| 100 15TH STREET NW | NORTON | VA | 24273 | 540566029 | HOSPITAL | VA | 501C3 | 3 | NA | false |
| DICKENSON COMMUNITY HOSPITAL | ||||||||||
| 312 HOSPITAL DRIVE | CLINTWOOD | VA | 24228 | 770599553 | HOSPITAL | VA | 501C3 | 3 | NCH | false |
| JOHNSTON MEMORIAL HOSPITAL | ||||||||||
| 16000 JOHNSTON MEMORIAL DRIVE | ABINGDON | VA | 24211 | 540544705 | HOSPITAL | VA | 501C3 | 3 | NA | false |
| ABINGDON PHYSICIAN PARTNERS | ||||||||||
| 16000 JOHNSTON MEMORIAL DRIVE | ABINGDON | VA | 24211 | 205485346 | MED. SERV. | VA | 501C3 | 12A | JHM | false |
| BALLAD HEALTH | ||||||||||
| 303 MED TECH PARKWAY SUITE 220 | JOHNSON CITY | TN | 37604 | 611771290 | SUPP. ORG | TN | 501C3 | 12B | NA | false |
| EAST TN HEALTHCARE HOLDINGS INC | ||||||||||
| 203 GRAY COMMONS CIRCLE | GRAY | TN | 37615 | 815475903 | OPIOID TRT | TN | 501C3 | 3 | MSHA | false |
| LAUGHLIN MEMORIAL HOSPITAL INC | ||||||||||
| 1420 TUSCULUM BOULEVARD | GREENEVILLE | TN | 37745 | 620701119 | HOSPITAL | TN | 501C3 | 3 | MSHA | false |
| LAUGHLIN HEALTHCARE FOUNDATION | ||||||||||
| 1420 TUSCULUM BOULEVARD | GREENEVILLE | TN | 37745 | 582105493 | FUNDRAISER | TN | 501C3 | 12A | MSHA | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| SAPLING GROVE AMB SURGERY CENTER | |||||||||
| 220 MEDICAL PARK BOULEVARD | BRISTOL | TN | 37620 | 204450153 | MED. SERV. | TN | N/A | false | false |
| HOLSTON VALLEY AMB SURGERY CENTER | |||||||||
| 103 WEST STONE DRIVE | KINGSPORT | TN | 37660 | 621816864 | MED. SERV. | TN | N/A | false | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|
| WELLMONT INC | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621320035 | MED. SERV. | TN | N/A | false |
| MCOT INC | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621325938 | BUS. SERV. | TN | N/A | false |
| MEDICAL MALL PHARMACY INC | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621565006 | MED. SERV. | TN | N/A | false |
| WELLMONT PHYSICIAN SERVICES INC | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621567353 | MED. SERV. | TN | N/A | false |
| WPS PROVIDERS INC | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 205564642 | MED. SERV. | TN | N/A | false |
| WELLMONT HEALTH SERVICES INC | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621254373 | MED. SERV. | TN | N/A | false |
| WELLMONT INSURANCE CO SPC LTD | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 981195624 | INSURANCE | N/A | false | |
| BLUE RIDGE MEDICAL MANAGEMENT CORP | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621490616 | MED. SERV. | TN | N/A | false |
| MEDISERVE MEDICAL EQUIPMENT | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621212286 | DME | TN | N/A | false |
| MOUNTAIN STATES PROPERTIES | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621845895 | PROP. MGMT | TN | N/A | false |
| MOUNTAIN STATES PHYSICIAN GROUP | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621700412 | MED. SERV. | TN | N/A | false |
| COMMUNITY HOME CARE INC | ||||||||
| 1490 PARK AVENUE NW SUITE B | NORTON | VA | 24273 | 541453810 | DME | VA | N/A | false |
| WILSON PHARMACY INC | ||||||||
| PO BOX 5289 | JOHNSON CITY | TN | 37604 | 620329587 | PHARMACY | TN | N/A | false |
| CRESTPOINT HEALTH INSURANCE COMPANY | ||||||||
| 509 MED TECH PARKWAY SUITE 100 | JOHNSON CITY | TN | 37604 | 620381170 | INSURANCE | TN | N/A | false |
| INTEGRATED SOLUTIONS HEALTH NETWORK | ||||||||
| 509 MED TECH PARKWAY SUITE 100 | JOHNSON CITY | TN | 37745 | 621711997 | HLTH NETWK | TN | N/A | false |
| NOLICHUCKEY MANAGEMENT SVCS INC | ||||||||
| 1420 TUSCULUM BOULEVARD | GREENEVILLE | TN | 37745 | 621776681 | MED. SERV. | TN | N/A | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | Yes (true) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |